Risk Behaviour and Addiction in Adolescence
A combination of lecture slides and notes.
Table of contents
Lecture 1: Introduction Risk Behav. & Addic. in Adolescence 1
Lecture 2: The role of peers - Lydia Laninga-Wijnen 7
Lecture 3: International teen trends in substance use: what’s driving them? - Margreet
de Looze 13
Lecture 4: The role of parents - Ina Koning 16
Lecture 5: Substane use prevention - Dr. Marloes Kleinjan 20
Lecture 6: Individual vulnerability for risk behaviour and addiction - Margot Peeters 27
Lecture 7: Neurobiological processes and behavioural mechanisms of addiction - Dr.
Heidi Lesscher 31
Lecture 8a: Changing risk behaviour and addiction 39
Lecture 8b: Treatment & comorbidity - Samui Winterwerp & Ferd Jan van Kemenade 42
, 1
Lecture 1: Introduction Risk Behav. & Addic. in Adolescence
1.How do we define risk behaviour?
- Risk behaviour = behaviours that pose a risk to a healthy physical, cognitive, and
psychosocial development of adolescents.
● Substance use: e.g., smoking/vaping, alcohol use, cannabis use, use of XTC
and other party/designer drugs.
● Other risk behaviours: e.g., (online) gambling, gaming, social media use.
The general developmental process of addiction
Contact with a substance → experimenting with a substance → integrated use → excessive
use → addicted use.
What we tend to regard as ‘risk behaviour’ depends on..
- Characteristics of the particular substance or behaviour
● For instance, smoking/vaping versus gaming.
- Cultural and societal norms:
● E.g. alcohol use in Western versus Islamic cultures.
- Scientific knowledge:
● E.g. knowledge of the risks of alcohol use for the cognitive development of
adolescents.
Experimenting with substances should be seen as risky behaviour because the line between
experimenting, integrated use and excessive use is thin.
● This does not apply to gaming, that’s a different case.
Predictors of (change in) risk behaviour [COM-B model, Michie et al., 2011]
The model above is part of the model below.
, 2
The behaviour change wheel
2.Which (neurological) developments take place during adolescence?
Adolescence (±10 - 24 years)
- Early adolescence (aged 10 -14): physical growth, sexual maturation, psychosocial
development, social identity formation.
- Mid adolescence (aged 15 – 17): experimenting with (risk) behaviours, and personal
identity formation.
- Late adolescence (aged 18 – 24): practising/experimenting with adult roles.
● E.g. getting a house, getting a job, etc.
Neurological development during adolescence
1) Strong growth in brain volume: increase in white matter (connections), but decrease
in grey matter (nerve cells).
a) The decrease in grey matter is earlier in girls than boys.
i) The brain of boys is bigger, so they have more grey matter at the
peak. This doesn’t say anything about their intelligence.
b) In adolescence the grey matter peaks and then decreases; pruning.
= the connections between neurons will be lost if they’re not frequently
used.
2) High plasticity and flexibility of the brain.
3) Increase in white matter: communication between brain regions strongly improves.
a) Long-term memory increases.
b) Capacity for abstract (critical) thinking and metacognition increases.
, 3
3.Why is there a peak in risk behaviours during adolescence?
Risk behaviour follows an inverted U-shaped curve.
Neurological development in adolescence
The speed of the development of two different brain regions differs.
● The affective-motivational system (emotional brain, reward centre) develops fast.
○ Nucleus accumbens.
○ The affective-motivational system (‘reward centre’) is overactive during early
and mid-adolescence.
○ Adolescents experience stronger positive emotions than adults when they
receive or anticipate a reward.
■ This process is enhanced by testosterone.
■ Boys act more on their risk behaviour, probably because they have
more testosterone.
● The control system (rational brain) develops slowly.
○ Prefrontal cortex.
○ The rational brain develops slowly (until about 25 years).
○ The rational brain plays an important role in the development of executive
functions:
■ Risk estimation
■ Monitoring long-term goals
■ Inhibit the tendency to respond to (short-term) possibilities for reward
(impulse control, behavioural inhibition, self-control).
The maturational imbalance model (Casey et al., 2011)
Increased risk-taking during adolescence is a
result of an imbalance between reward sensitivity
(the affectivemotivational system) and impulse
control (control system).
● Dotted line = reward sensitivity.
● Straight line = impulse control.
A combination of lecture slides and notes.
Table of contents
Lecture 1: Introduction Risk Behav. & Addic. in Adolescence 1
Lecture 2: The role of peers - Lydia Laninga-Wijnen 7
Lecture 3: International teen trends in substance use: what’s driving them? - Margreet
de Looze 13
Lecture 4: The role of parents - Ina Koning 16
Lecture 5: Substane use prevention - Dr. Marloes Kleinjan 20
Lecture 6: Individual vulnerability for risk behaviour and addiction - Margot Peeters 27
Lecture 7: Neurobiological processes and behavioural mechanisms of addiction - Dr.
Heidi Lesscher 31
Lecture 8a: Changing risk behaviour and addiction 39
Lecture 8b: Treatment & comorbidity - Samui Winterwerp & Ferd Jan van Kemenade 42
, 1
Lecture 1: Introduction Risk Behav. & Addic. in Adolescence
1.How do we define risk behaviour?
- Risk behaviour = behaviours that pose a risk to a healthy physical, cognitive, and
psychosocial development of adolescents.
● Substance use: e.g., smoking/vaping, alcohol use, cannabis use, use of XTC
and other party/designer drugs.
● Other risk behaviours: e.g., (online) gambling, gaming, social media use.
The general developmental process of addiction
Contact with a substance → experimenting with a substance → integrated use → excessive
use → addicted use.
What we tend to regard as ‘risk behaviour’ depends on..
- Characteristics of the particular substance or behaviour
● For instance, smoking/vaping versus gaming.
- Cultural and societal norms:
● E.g. alcohol use in Western versus Islamic cultures.
- Scientific knowledge:
● E.g. knowledge of the risks of alcohol use for the cognitive development of
adolescents.
Experimenting with substances should be seen as risky behaviour because the line between
experimenting, integrated use and excessive use is thin.
● This does not apply to gaming, that’s a different case.
Predictors of (change in) risk behaviour [COM-B model, Michie et al., 2011]
The model above is part of the model below.
, 2
The behaviour change wheel
2.Which (neurological) developments take place during adolescence?
Adolescence (±10 - 24 years)
- Early adolescence (aged 10 -14): physical growth, sexual maturation, psychosocial
development, social identity formation.
- Mid adolescence (aged 15 – 17): experimenting with (risk) behaviours, and personal
identity formation.
- Late adolescence (aged 18 – 24): practising/experimenting with adult roles.
● E.g. getting a house, getting a job, etc.
Neurological development during adolescence
1) Strong growth in brain volume: increase in white matter (connections), but decrease
in grey matter (nerve cells).
a) The decrease in grey matter is earlier in girls than boys.
i) The brain of boys is bigger, so they have more grey matter at the
peak. This doesn’t say anything about their intelligence.
b) In adolescence the grey matter peaks and then decreases; pruning.
= the connections between neurons will be lost if they’re not frequently
used.
2) High plasticity and flexibility of the brain.
3) Increase in white matter: communication between brain regions strongly improves.
a) Long-term memory increases.
b) Capacity for abstract (critical) thinking and metacognition increases.
, 3
3.Why is there a peak in risk behaviours during adolescence?
Risk behaviour follows an inverted U-shaped curve.
Neurological development in adolescence
The speed of the development of two different brain regions differs.
● The affective-motivational system (emotional brain, reward centre) develops fast.
○ Nucleus accumbens.
○ The affective-motivational system (‘reward centre’) is overactive during early
and mid-adolescence.
○ Adolescents experience stronger positive emotions than adults when they
receive or anticipate a reward.
■ This process is enhanced by testosterone.
■ Boys act more on their risk behaviour, probably because they have
more testosterone.
● The control system (rational brain) develops slowly.
○ Prefrontal cortex.
○ The rational brain develops slowly (until about 25 years).
○ The rational brain plays an important role in the development of executive
functions:
■ Risk estimation
■ Monitoring long-term goals
■ Inhibit the tendency to respond to (short-term) possibilities for reward
(impulse control, behavioural inhibition, self-control).
The maturational imbalance model (Casey et al., 2011)
Increased risk-taking during adolescence is a
result of an imbalance between reward sensitivity
(the affectivemotivational system) and impulse
control (control system).
● Dotted line = reward sensitivity.
● Straight line = impulse control.
